Workplace wellness programs are intended to improve and promote health and fitness, usually through mechanisms promoted or offered by an employer. Common programs include smoking cessation, diabetes management, weight loss, and preventive health screenings. According to a 2016 Employer Health Benefits Survey, 83% of large firms (200+ employees) offer a wellness program and 42% of those large firms offer financial incentives for employee participation. Some even mandate participation.
Proponents of workplace wellness programs argue that an employer’s commitment to its employees’ health will reduce the company’s healthcare costs in the long-run. According to Eric Zimmerman of Redbrick Health, "Employers are spending hundreds of millions of dollars on health care, in fact an average of $12,000 per employee. So it doesn’t seem imprudent to spend a small percentage of that on keeping people healthy.”
“If you invest and focus on the health of your population,” says David Nill, chief medical officer of wellness vendor Cerner Health, “you will be happier, healthier, and more productive.”
But not everyone loves workplace wellness initiatives. Opponents of these programs claim that companies actually spend more money on these programs because of increased rates of employees’ procuring expensive tests and unnecessary doctor visits. Further, these programs often collect very sensitive health information but maintain impermissibly lax privacy policies. There’s also little to no evidence that this increased emphasis on wellness in the workplace actually improves employee health in the long run.
When companies first started implementing these programs in the 1990s, it sounded like a win-win: save money and keep your employees healthy by detecting any health issues before they get expensive. Then, in 2006, employers began linking financial rewards to health outcomes; to do this, they began to make the "unhealthy" people (or those who didn’t participate in the programs) pay more.
Not everyone was happy about this. A group of health advocacy organizations, including the American Diabetes Association and the American Lung Association, wrote a letter to Congress pleading “that individuals not be penalized—either financially or by exclusion from coverage or services—if they are sick or if they presently engage in specific behaviors or have certain health conditions, such as smoking or obesity.” It turned out that some of the people who most needed health services were seeing their costs driven up because of their inability to participate.
Others object to screening asymptomatic, healthy people in an attempt to mitigate future health crises. Such screenings can generate false alarms by detecting abnormalities that would never have developed into a disease. Some of these patients are then subjected to treatments “just to be safe,” exposing them to unnecessary surgeries or medication side effects.
So how can the goal of healthier employees be achieved? It seems that, to improve employee health, companies should redefine their wellness programs. A few of our suggestions:
- Ensure that participation is 100% voluntary, never mandated
- Provide real benefits to the employee (ie., not just about saving the employer money)
- Don’t link program participation to financial incentives
- Offer reimbursements for employees’ everyday wellness expenses (yoga, gym membership)
- Offer in-office fitness classes or massage therapy
- Develop a generous sick leave policy to keep ill employees at home, reducing contagions
How can you work with wellness programs?
Some providers, like physical therapists or massage therapists, frequent large employers’ offices to provide wellness screenings or consultations. Others offer “concierge” services, wherein they visit their patient’s office and provide treatment on-site. These are great ways to work with your busy patient population, especially when their workplace encourages such wellness activities, but it can create unexpected problems, including: insurance coverage for the visit, privacy concerns, and impermissible referral agreements. Further, remember that your services need to be medically necessary – something that may be challenging to establish if your patient is asymptomatic.
If you have an opportunity to participate in something like this, let’s chat about how you can do so without running afoul of the law – your patients and pocketbook will thank you (not to mention, you’ll sleep better at night knowing that you’re doing things the right way). It’s a simple process of setting up your corporate entity, establishing your privacy policies, and educating you about your possible liabilities and risks. So grab that opportunity, and let’s get to work!
about the author
Erin Jackson is Jackson LLP's Managing Partner. She is responsible for all aspects of firm management, is a sought-after speaker for healthcare conferences, and is a published author. She is specifically focused upon the intersection of the patient experience in healthcare with the legal and ethical responsibilities of providers.
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